MEDICARE: HUMARA S GULL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	K1456	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164537320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUMARA S GULL MD

Provider Business Mailing Address
First Line	:	11331 N SAM HOUSTON PKWY E
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-4598
Country	:	US
Telephone Number	:	281-459-9181
Fax Number	:	281-459-9813

Provider Business Practice Location Address
First Line	:	11331 N SAM HOUSTON PKWY E
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-4598
Country	:	US
Telephone Number	:	281-459-9181
Fax Number	:	281-459-9813

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	05/11/2026

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